(Revised, February 2023) CERTIFICATE OF CONSENT/RELEASEMWAIVER . a Filipino citizen, {Gran Rae BGS Nae a EROS STS TT of legal age, and a resident of hereby, deciare that: FF Teens Rasa) 1. | understand that the Civil Service Commission (CSC) is conducting the on Tied Baeraiay Baie a Bator 2. 1am participating in said examination as: Q Examinee O Examiner 3. 1am fully aware of the continuing existence of the Corona Virus Disease (COVID- 19) and its potential health threats/risks. 4. lunderstand that all known precautions and health safety protocols, in accordance with the Omnibus Guidelines of the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases, to ensure my safely are taken/instituted by the CSC in and for the conduct of the examination. 5. | understand that it is my responsibility to comply with the required precautionary measures such as, but not limited to, wearing of face mask, hand sanitizing as often as possible, and physical distancing, as may be applicable in my case. 6. | understand that, despite taking all known precautions and health safety protocots, exposure to COVID-19 is an ever-present risk for which my absolute safety or protection from potential contracting of the virus in the conduct of the examination isn ‘cannot be quar : With my full knowledge and understanding of the above declarations, | hereby wholly give ‘my consent and confirm my participation on my own free will and volition in the conduct tt on of the, (Tie of Examiration) (ate of Examneion) Accordingly, | set CSC entirely free from any liability or responsibility in the event that | contract COVID-19 during the period of the aforementioned examination. ‘Signature over printed full name of examinee/examiner Date Signature over printed fullname of witness Date ‘Announcement 1 June 2023 VOLT / Pe 7017 b